Gary Johnson on Health Care

Libertarian presidential nominee; former Republican NM Governor

Government-managed healthcare is insanity

Government has never managed any segment of the economy successfully. To expect that it can do so for health care--one of the largest segments--is insanity. Nowhere is it more important that the best possible services and products be available
at affordable prices than in the area of health. Government simply cannot fulfill that mission. Rather, real competition, freedom to innovate and a working marketplace will provide Americans with the health care they want and will demand.

To the extent that we, as a society, want to help those who are truly in need, that help can best be provided by the states--with any federal assistance coming in the form of block grants to
be applied to best practices, innovative programs and the most efficient delivery of services.

Block grant Medicare; carte blanche to the states

Q: You told the Wall Street Journal last year that you support means testing for Medicare and Social Security, for which you said you would raise the eligibility age. In what specific ways would you cut entitlement programs to balance the budget?

A: Specifically, and this is waving the magic wand, because I recognize that there are three branches of government, I would have the federal government cut Medicare and Medicaid by 43% and block grant the programs [to the states] with no strings.
Instead of giving the states one dollar--and it's not really giving because there are strings attached--the federal government needs to give the states 57 cents, take away the strings and give the states carte blanche for how to give health care to the
poor. I reformed Medicaid as governor of New Mexico and, in that context, even with strings attached, I believe I could have delivered health care to the poor. I believe I could have done the same thing with Medicare.

Salud!: managed care for Medicaid recipients

Governor Johnson has an excellent record of holding down the exploding growth of entitlement programs that now cripple state budgets. As Governor, Johnson presided over the beginning of managed care for Medicaid recipients in
New Mexico and pushed for speedy implementation. The managed care program (known as Salud!) replaces fee-for service and covers approximately two-thirds of available services under Medicaid.
Salud! has generally been described as operating with "significant savings to both the State and Federal governments," when compared to fee-for-service.

In 2002, Johnson proposed limiting eligibility for Medicaid from 235% of the federal poverty level

1999: vetoed 12-cent-a-pack cigarette tax hike

Unlike some of the other Republican candidates for President, Gary Johnson never raised the cigarette tax. While the tax on cigarettes has little relevance to economic growth, the fact that he held the line on such taxes demonstrates how strongly he
opposes tax hikes. In 1999, he vetoed a 12-cent-a-pack cigarette tax hike --not because he liked smoking, he says, but because he opposes all tax hikes. New Mexico's cigarette tax rate stayed the same from 1995 to 2003.

Cut Medicare/Medicaid by 43%, as part of $1.675 trillion cut

Q: How do you stop the deficits and out of control spending?

A: I'm under the belief that we are on the verge of a financial collapse. And we have no ability to repay $14 trillion in debt if we're racking up
$1.6 trillion in deficit spending in deficit spending this year, and the years looking ahead. Look, we're not going to pay back $14 trillion in debt. We have to embark on balancing the federal budget tomorrow.

Q: How?

A: Well, cutting $1.675 trillion from the federal government. You got to start out by talking about Medicare and Medicaid by 43 percent. They could block grant the states, 50 laboratories of innovation. Give it to the states to deliver health care to the
poor and those over 65 and do away with the strings. Do away with that regulations; let states handle it. There would be best practices emerge. Other states would emulate the best practices. They're be failure. States would avoid the failure.

Repeal ObamaCare & failed Medicare prescription drug benefit

Government spends too much because it does too much. Unchecked deficits are the single greatest threat to our national security. Unless we take significant steps soon, our federal debt will equal the entire economic production of the United States.
We should start by reassessing the role of the federal government, and always asking the question: Should the government be doing this in the first place? We must act now to enact responsible entitlement reform:

Identify and implement common-sense
cost savings to place Medicare on a path toward long-term solvency.

Block grant Medicare and Medicaid funds to the states, allowing them to innovate, find efficiencies and provide better service at lower cost.

Repeal ObamaCare, as well as the
failed Medicare prescription drug benefit.

Fix Social Security by changing the escalator from being based on wage growth to inflation. It's time for Social Security to reflect today's realities without breaking trust with those soon to retire.

No federal pre-emption of employee health plan regulation.

Johnson adopted the National Governors Association position paper:

The Issue

In 1999, 42.6 million Americans did not have health insurance. All states have been fervently working to reduce the number of uninsured Americans, to make health insurance more affordable and secure, and to provide quality health care at a reasonable cost to the uninsured. However, the federal government has also expressed an interest in this issue. Any action taken at the federal level could have serious implications for traditional state authority to regulate the health insurance industry and protect consumers.

NGAís Position

Although the Governors are extremely sensitive to the concerns of large multi-state employers, the fact remains that the complete federal preemption of state laws relating to employee health plans in the Employment Retirement Income Security Act (ERISA) is the greatest single barrier to many state reform and patient protection initiatives.

The Governors support efforts designed to enable small employers to join together to participate more effectively in the health insurance market. In fact, Governors have taken the lead in facilitating the development of such partnerships and alliances. However, these partnerships must be carefully structured and regulated by state agencies in order to protect consumers and small businesses from fraud and abuse and underinsurance. NGA opposes attempts to expand federal authority under ERISA. The Governors have identified the prevention of such federal legislation in the 107th Congress as a top legislative priority.

States have the primary responsibility for health insurance regulation. Across the nation, Governors are working to protect consumers and patients and to properly regulate the complicated health insurance industry.

More federal funding for rural health services.

Johnson signed the Western Governors' Association resolution:

Western Governors want rural areas to have an adequate and able workforce to deliver needed health care services. The governors call on the federal government to provide necessary funding for programs such as the National Health Service Corps (NHSC) that have a state-based component, and the Health Professions programs that help health professionals serve in rural and frontier areas.

Western Governors believe that rural health care providers should be paid fairly by Medicare in order to ensure access to health care for rural citizens. The governors encourage the federal government to take further steps to ensure equity in Medicare reimbursement for urban and rural areas.

Alaska, Hawaii, America Samoa, the Northern Mariana Islands and Guam face extraordinary geographic barriers in providing healthcare services and they should be designated for special consideration and adequate funding to overcome their frontier barriers.

Federal programs like the Rural Health Outreach Grants and the Rural Hospital Flexibility program need to continue to provide funds to states and communities to experiment with new programs, integration of services and coalition building to develop new types of providers, facilities, and services.

Western Governors believe in strengthening the existing health care system. Support for home health agencies, rural health clinics, public health nursing and critical access hospitals are partial solutions.

Western Governors support the elimination of barriers to the use of telemedicine as outlined in the WGAís 1998 report. In particular, we request that the federal efforts to increase reimbursement for telemedicine consultations, to protect the privacy of patient-identifiable medical information and to support rural health provider telecommunication costs with universal service funds continue.

Protect state tobacco settlement funds from federal seizure.

Johnson adopted a letter to Congressional leaders from 53 Governors:

As you know, preserving and protecting the state tobacco settlement funds is the nationís Governorsí highest priority. We strongly urge you to reach final agreement and pass the conference report on the emergency supplemental appropriations bill soon, and to retain the Senate provision that protects our settlement funds from federal seizure.

Many of our state legislatures are currently in session, and some have already completed work on their budgets. Therefore, it is critical that conferees reach agreement quickly on this issue. Governors are unified in their commitment to ensuring that the funds remain in the states and that there be no restrictions on statesí ability to tailor spending to meet the needs of their citizens.

We offer our strongest support for conferees to recede to the Senate version of the bill containing the Hutchison/Graham bipartisan tobacco recoupment protection legislation.